A unique challenge inherent in the study of multi-component mind-body interventions is objectively quantifying measures of adherence, proficiency, and functional dosage. Because variability in proficiency of practice can significantly alter physiological responses to a period of training, simple measures of class attendance or logged practice time are unlikely to capture components of dosage needed to objectively evaluate efficacy, safety, and underlying mechanisms of mind-body interventions. This Phase I SBIR application submitted by HRO Enterprises Inc, in collaboration with biomotion and mind- body researchers from Harvard Medical School, will leverage advances in wearable technology to develop a system that allows mind-body researchers to gather objective measures of adherence, proficiency and dosage. Our approach will build upon the already successful SHIMMER (Sensing Health with Intelligence, Modularity, Mobility, and Experimental Reusability) system, a commercially available platform designed explicitly for wearable non-invasive health sensing applications. Initially focusing on biomotion related aspects of adherence, proficiency and dosage, we will use wireless kinematic sensors (i.e. accelerometers and gyroscopes and force sensors) to capture distinct patterns of movement that are associated with the performance of Tai Chi and that would provide a means to assess adherence to, and proficiency of practice. Our application includes three Specific Aims: (1) To integrate the SHIMMER platform into the design of a wearable, wireless system suitable to monitor practice/training sessions; (2) To demonstrate that inertial sensors (i.e. accelerometers and gyroscopes) can capture aspects of movement biomechanics associated with the performance of Tai Chi exercise; and (3) To show that features derived from wearable sensor data can capture adherence and proficiency in the performance of Tai Chi exercise, and correlate with quantitative assessments of proficiency provided by a panel of Tai Chi experts. These initiatives will lay the groundwork for Phase II of this project in which we plan to 1) fully develop a wearable wireless system ready to be commercialized for the assessment of adherence and proficiency of performance of Tai Chi and related mind-body exercises, 2) develop and assess feedback modalities to guide mind-body practitioners and instructors in optimal training strategies, and 3) prospectively evaluate the system in clinical trials to assess changes in proficiency and dose and how they correlate with clinical outcome. PUBLIC HEALTH RELEVANCE: Mind-body exercises such as Tai Chi, Yoga, and Qigong show substantial promise for the prevention and rehabilitation of many medical conditions, and are among the fastest growing complementary and alternative medicine (CAM) therapies in the United States. We propose development of technology that uses wireless wearable sensors to measure adherence, proficiency, and dosage in mind-body interventions in the context of clinical trials. The device will also provide feedback to improve the training quality of practitioners, and to guide instructors in developing optimal training strategies.